An Unusual Method of Suicidal Ligature Strangulation

This article reports a case of suicidal strangulation by ligature of a 51‐year‐old woman with a psychiatric disorder. She had been suffering from depression with a history of previous suicidal attempt. The deceased accomplished self‐strangulation using two ligatures, with one placed above the other and consisting of a satin fabric and a shoelace. The underlying shoelace ligature was fastened by a secure fixed square knot at the back of the neck. The overlying fabric piece was tied with a half‐knot under the chin and was tightened around the neck manually. A detailed investigation and autopsy examination strongly suggests suicide. The case is of interest due to its rarity and uncommon method of execution.     

Knot‐Tying Habits,Tier Handedness,and Experience*

Abstract: Previous research concerning tier handedness, experience and the configuration of simple, habitual knots has been scant and conflicting. Survey data were collected from 21 disparate groups comprising 562 respondents in total. Regardless of experience, respondents tied both Granny and Reef Knots. Dextral tying was dominated by S knots. Left‐handers tied Z knots more frequently than right‐handers. However, the frequency of S and Z knots relative to tier hand dominance, which is not binary, occurred on a continuum. Averaging all survey tasks, more than 70% of knots tied by dextrals were S, whereas only 56% of those tied by sinistrals were S. These percentages varied somewhat according to specific tying tasks and the number of working ends. Furthermore, tiers’ shoelace and parcel knots were not always identical, and a ranked pattern in parcel and shoelace knots was revealed. The examination of habitual knots could benefit criminal investigations.     

Different Mechanisms of Decapitation: Three Classic and One Unique Case History

Abstract: Three classic cases and one exceptional case are reported. The unique case of decapitation took place in a traffic accident, while the others were seen after homicide, vehicle‐assisted suicide, and after long‐jump hanging. Thorough scene examinations were performed, and photographs from the scene were available in all cases. Through the autopsy of each case, the mechanism for the decapitation in each case was revealed. The severance lines were through the neck and the cervical vertebral column, except for in the motor vehicle accident case, where the base of skull was fractured. This case was also unusual as the mechanism was blunt force. In the homicide case, the mechanism was the use of a knife combined with a saw, while in the two last cases, a ligature made the cut through the neck. The different mechanisms in these decapitations are suggested.     

Putting homicide followed by suicide in context: Do macro‐environmental characteristics impact the odds of committing suicide after homicide?*

Homicide followed by suicide remains an understudied phenomenon in the criminological literature. This is due, in part, to methodological and statistical limitations—much of the extant research includes small samples and has not kept pace with quantitative advances. Moreover, scholarship on homicide–suicide has been focused almost exclusively on individual risk factors, discounting contextual influences. In this study, we examine whether macro‐environmental characteristics affect the odds of suicide after a homicide. We use data on 24,373 homicide and homicide–suicide cases distributed across 3,019 cities and 48 U.S. states from the National Violent Death Reporting System to examine the direct effects of structural factors on the odds of suicide after a homicide; and whether structural characteristics condition the impact of the victim–offender relationship on the odds of homicide–suicide. Hierarchical logistic regression models indicate that macro‐level concentrated disadvantage decreases the odds of homicide–suicide. Furthermore, concentrated disadvantage attenuates the odds of suicide after the homicide of an intimate partner, child, family member, or friend, relative to the killing of a stranger. The findings reveal that researchers should account for the context in which homicide–suicide occurs; failure to do so may unintentionally discount a key correlate of homicide–suicide and artificially inflate the effects of the micro‐environment.     

Complex Suicide by Self‐stabbing and Drowning: A Case Report and a Review of Literature

Sharp force injuries and drowning are methods exceptionally combined in complex suicides. We report a challenging case of complex suicide by self‐stabbing and drowning that illustrates the difficulty in discriminating between homicide and suicide in such circumstances of death. The corpse of a young man was found submerged in a river, stabbed nine times with two wounds that had penetrated the thorax and had caused lung injuries and a hemopneumothorax. The postmortem and histological examinations were consistent with a death caused by drowning, but the manner of death still remained undetermined. Police investigation finally concluded to a suicide, although no suicide note had been left and the victim had no underlying diagnosed mental disorder. The parameters that may help distinguish suicide from homicide at the autopsy should be interpreted in light of a thorough forensic investigation to determine the exact manner of death in such a case.     

Determined to Die! Ability to Act Following Multiple Self‐inflicted Gunshot Wounds to the Head. The Cook County Office of Medical Examiner Experience (2005–2012) and Review of Literature

Cases of multiple (considered 2+) self‐inflicted gunshot wounds are a rarity and require careful examination of the scene of occurrence; thorough consideration of the decedent's psychiatric, medical, and social histories; and accurate postmortem documentation of the gunshot wounds. We present a series of four cases of multiple self‐inflicted gunshot wounds to the head from the Cook County Medical Examiner's Office between 2005 and 2012 including the first case report of suicide involving eight gunshot wounds to the head. In addition, a review of the literature concerning multiple self‐inflicted gunshot wounds to the head is performed. The majority of reported cases document two gunshot entrance wound defects. Temporal regions are the most common affected regions (especially the right and left temples). Determining the capability to act following a gunshot wound to the head is necessary in crime scene reconstruction and in differentiation between homicide and suicide.     

2633例机械性窒息法医尸检资料回顾性研究

本文根据湖北省部分地区1957～1986年间尸检记录,收集并分析了2633例机械性窒息死的出现率、案情性质、城市与乡村的差别等问题,为法医学实践提供了可供参考的资料。     

Suicide by multiple blunt head traumatisation using a stone

Apart from collisions with road or rail vehicles and falls from height, self inflicted blunt force is a rare suicide method and mainly seen in psychiatric patients. The paper presents a rare case of suicide by active blunt force. A 68-year-old man committed suicide by repeatedly hitting his head with a stone. He sustained a craniocerebral trauma and finally died from hypothermia due to the low outdoor temperature. According to the relatives, the man was not diagnosed with a mental disorder or suicidal tendencies. Uncommon manners of self-harm are challenging for those involved in the investigation, and a differentiation between suicide, accident and homicide can only be made in synopsis of all findings.     

Self‐Strangulation Turning into Partial Hanging for a Suicide Victim

Hanging is the most common asphyxial method of suicide, whereas suicide by strangulation is unusual. Here, we are reporting a particular methodology of the asphyxial method of suicide in which a case of self‐strangulation culminated into partial hanging. A 30‐year‐old male wrapped one end of the cable wire around his neck. He then passed the other end over a curtain rod and tied that end around the right hand. He pulled the hand down, using the curtain rod as a fulcrum, to tighten the noose around the neck in an attempt to strangulate himself. However, he lost consciousness during the process and the body slipped down, pulling the right hand up which got stuck at the curtain rod. This led the body hanged in the kneeling position. This bizarre scenario raised suspicion of homicide but the crime scene, autopsy and victim characteristics were in favor of suicide.     

Homicide‐Suicide in Konya,Turkey Between 2000 and 2007*

Abstract: Homicide followed by the suicide of the murderer is a relatively rare lethal incident in which an individual kills another person and subsequently dies by suicide. Cases involving a homicide and a suicide in which death examinations and autopsies were performed at The Konya Branch of the Forensic Medicine Council between 2000 and 2007 were retrospectively investigated. During the studied time period, there were 10 homicide‐suicide cases identified with 10 perpetrators killing 12 victims. Nine of the perpetrators were men and eight of the victims were women. The precipitating motive was an impending divorce in four of the cases. Two perpetrators were described as severely depressed, one had a diagnosis of antisocial personality disorder, and one was a pedophile who had reactive depression. Firearms were used in eight of the homicide cases and seven of the suicides. Constricting the use of firearms may reduce/prevent future homicide‐suicide cases, as it is the most commonly used method to carry out homicide‐suicides.     

Homicide by ligature strangulation in Finland: offence and offender characteristics

In Finland, homicide by ligature strangulation is a rare event. The purpose of this study was to investigate recent homicide cases by ligature strangulation and to analyse offence and offender characteristics. All forensic psychiatric evaluation statements of offenders accused of ligature strangulation homicides during the 7-year period 1996--2002 (n=19) were reviewed retrospectively. Thirty-five percent of the victims were females. In four cases, the victim was the offender's intimate partner; in one case, it was the stepson; in one case, a father and in the rest of the cases (n=13), an acquaintance. None of the cases involved planning, sadism or sexual elements. In 89% of the cases, the offender was either intoxicated or on drugs at the time of the offence and in 94% of the cases, the victim was found at the scene of the killing. Of the offenders, 63% had crime history, and approximately half of the offenders had experienced parental alcohol abuse, domestic violence or previous trauma. Most of the offenders were unemployed at the time of the offence. In all, 89% were diagnosed as having personality disorder and two were schizophrenic.     

Screening for suicide risk factors in prison inmates: Evaluating the efficiency of the Depression,Hopelessness and Suicide Screening Form (DHS)

The Depression, Hopelessness and Suicide Screening Form (DHS; Mills & Kroner, 2002 ) is a recently developed self‐report instrument to aid in screening inmates in the titled areas. Research has shown the DHS to have good internal consistency, factor structure and construct validity. The present study extends the previous validation research by comparing the disclosure of suicide risk factors on the DHS with both interview‐based and file review information. In addition, the DHS scores were used to predict psychological distress. The results indicate that despite the paper‐and‐pencil self‐report approach of the DHS it is comparably efficient in gathering suicide risk factors to other methods. In addition, the predictive accuracy of the DHS in identifying inmates experiencing psychological distress was confirmed. The current study has implications for the method of collection of suicide screening information. The discussion centres on the potential of self‐report in screening for suicide and self‐harm indicators in inmate populations.     

National study comparing the characteristics of patients diagnosed with schizophrenia who committed homicide vs. those who died by suicide

Associations between serious mental disorder and violence are well-documented, but there is little epidemiological evidence linking these disorders and homicide risk. The reported study compares socio-demographic and clinical characteristics of people diagnosed with schizophrenia who committed homicide vs. those who died by suicide. The study is a national case series of male patients in England & Wales diagnosed with schizophrenia and convicted of homicide during 1997–2012 (n = 168), and a randomly selected comparison group of male patients with schizophrenia who died by suicide and who were matched to the homicide case series by age (n = 777). There are different patterns of behaviour in people with schizophrenia preceding homicide and suicide. Homicide perpetrators have frequently disengaged with services whilst patients who die by suicide are often in recent contact. This is important knowledge for clinical services as it indicates a different preventive emphasis despite the existence of other shared characteristics.     

Simultaneous Homicide–Suicide: A Case Report of Double Drowning

Homicide–suicide is a tragic phenomenon which typically does not result in a criminal charge or trial. However, correct diagnosis and classification of homicide–suicide cases are important to determine the perpetrators and dynamics of each category properly. The deaths in the homicide–suicide acts can be divided into two categories with respect to the number of involved individuals: dyadic deaths and triple or multiple deaths. These two categories can also be divided into two subgroups according to the chronology of the incidents: simultaneous deaths and consecutive deaths. Herein, a simultaneous homicide–suicide case of a father and daughter where both deaths occurred through drowning which was not found in the selected literature review and where the victim was a child is presented. The article aims to clarify the term discrepancies about multiple death cases in the literature and to discuss the pathological and psychosocial characteristics of the simultaneous dyadic death cases.     

Criminal burning

We report a study of 40 burnt bodies on which an autopsy was carried out at the Institut de Médecine Légale in Lyon (28 men/12 women, average age = 41 years, minimum age = 3 years, maximum age = 86 years). Criminal deaths (31%) represented the second cause of death after accidents (52%), and before suicide (16%). Criminal burning seemed mainly to be means of covering up homicide, whereas criminal immolation was rarer. The particular characteristics of each of these situations have been highlighted (tying or poisoning in criminal immolation). We deemed it essential to make X-rays, to look for injuries due to trauma and to carry out systematic toxicological analyses in a victim of burning.     

Hesitation Wounds and Sharp Force Injuries in Forensic Pathology and Psychiatry: Multidisciplinary Review of the Literature and Study of Two Cases

The aim of this paper was to showcase the significant diagnostic value of hesitation wounds in terms of forensic, psychiatric, and medicolegal interest. A number of studies were reviewed to update and summarize the relevant literature on the incidence, distribution, character, and function of hesitation wounds as well as the sociodemographic variables and psychopathology of the inducers. This study also investigates their importance as a forensic criterion in the distinction between suicide and homicide as well as a psychiatric diagnostic tool in suicide prevention. In addition, the paper reports two new cases. Results conclude that there is equal incidence, but different distribution of hesitation wounds between genders. Furthermore, the low dispersion of hesitation wounds contrasts with the high dispersion of defense wounds. The inducers' psychopathology lies principally in Axis I disorders. Finally, there is a comprehensive analysis of non‐suicidal self‐injury and the role of self‐wounding in suicide prevention.     

Homicidal and suicidal ligature strangulation--a comparison of the post-mortem findings

Suicides by ligature strangulation are rare events. In Berlin (3.5 million inhabitants; ca. 500 suicides per year) approximately one case per year occurs. Here, we present the main findings of 19 cases investigated between 1978 and 1998, compared to 47 cases of homicidal ligature strangulation. Two of the 19 suicidal victims had single fractures of the upper thyroid horns and one victim a fracture of a lower thyroid horn; other types of laryngohyoid injuries were not observed. In the homicidal series, the laryngohyoid structures were unaffected in 26 cases (12 of these victims were children or adolescents), single thyroid horn fractures were present in three cases and more significant injuries in 18 cases. Macroscopic bleedings of the laryngeal muscles were found in 12 victims of the homicidal group and in none of the suicidal. Bleedings in the neck muscles seldom occurred in suicides. According to these findings, the laryngohyoid injuries can be helpful in the differentiation of suicide from homicide, if more than a single thyroid horn fracture or a laryngeal soft tissue trauma is present.     

Suicidal decapitation using a tractor loader: a case report and review of the literature

In forensic practice, decapitated bodies are predominantly associated with decapitation by wheels of trains or with postmortem dismemberment following homicide. In the suicidal context, decapitation accounts for less than 1% of total suicide. Apart from decapitation by trains, other encountered methods involve suicidal hanging and vehicle-assisted ligature suicide. Reported here is a unique case of suicidal decapitation in a 45-year-old man using a tractor loader at the foot of a silo, on his farm. The head was recovered in the loader and there were several impact spots from the loader as well as blood on the silo wall. The autopsy revealed a complete decapitation wound with the severance plane located between the third and fourth cervical vertebra. A 1.5 cm wide abrasion on the anterior part of the neck and abrasions under the chin were noted. This very unique case of intentional suicidal decapitation is the first reported case of a planned system intended to create decapitation outside the unique case of homemade guillotine and the more common decapitation by train.     

Direction, site and the muzzle target distance of bullet in the head and neck at close range as an indication of suicide or homicide

Direction, site and muzzle target distance can indicate suicide or homicide. This conclusion can be drawn from autopsies of 57 cases of suicide and 68 cases of homicide by handgun fired at close range to the head and neck together with going to the crimescene in some cases. This study was carried out in Bangkok during the period from January 1983 to January 1986. In order to determine whether it was suicide or homicide, the path of the bullet, the site, the muzzle target distance must be considered. The angle of the bullet would be either elevated (from below upward), horizontal or an angle of depression (from above downward). For suicide, the direction of the bullet should be at an angle of elevation in the majority of cases. The position of the handgun in relation to the head in suicide was most often in tight contact and near contact. For homicide, the direction of the bullet should be horizontal in most cases. The bullet was at close range in the majority of the cases. There are 8 common sites for suicide and homicide and 10 different sites in the case of homicide which are at neck, left cheek, left aural region, lip, left occipital area orbit, chin, left eyebrow, submental and nose.